My name is Tiana Adams, and I am a practicing Physician Assistant with 18 years of clinical experience. During this time I have worked in many specialties, including Family Practice, Urgent Care, Occupational Medicine, Orthopedics and Breast Cancer Surgery. Currently, I am the Oncology Operations Specialist at Ambry. Moving into this role is something new and exciting for me. I look forward to lending my expertise at Ambry in various ways, including this blog post that focuses on the signs and symptoms of breast cancer – something very important to me, after having worked with many families impacted by the disease.

Breast cancer affects women and men of all walks of life. It does not discriminate against age, ethnicity or financial status. In the U.S., roughly 1 in 8 women is at risk for developing breast cancer. The key to detecting breast cancer women and men is awareness and preventive care. Bill Rotter discussed what cancer can feel like for men in his recent post. We also need to make women more aware of the signs and symptoms of breast cancer so we are prepared to recognize it if it does happen, and not neglect what could potentially kill us, if left untreated.

To that end, I hope to share some signs and symptoms of breast cancer with you here, in two categories. The first will discuss early breast cancer signs; the second will talk about those of late stage breast cancer, also known as metastatic breast cancer.

Early breast cancer

In its early stages, breast cancer usually has no symptoms when it is small and most treatable. Therefore, it is very important for women to follow recommended screening guidelines for detecting breast cancer at the early stage before symptoms develop. As a cancer develops, you may note the following signs:

1. A painless lump in the breast or underarm that persists after your menstrual cycle. This is often the first apparent sign of breast cancer.

2. Swelling in the armpit and or breast. Breast swelling can be caused by an infection, also known as mastitis or it can be caused by inflammatory breast cancer, a particularly aggressive form of the disease.

3. Pain or tenderness in the breast. Although lumps are usually painless, pain or tenderness can be a sign of breast cancer.

4. A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.

5. A change in the nipple, such as a nipple retraction, dimpling, itching, a burning sensation or ulceration. A scaly rash of the nipple is symptomatic of Paget’s disease, which may be associated with an underlying breast cancer.

6. The presence of microcalcifications, radial scar or asymmetry on mammogram.

7. And finally, any area that is distinctly different from any other area on either breast.

Late stage breast cancer (including locally advanced and metastatic breast cancer)

When breast cancer is invasive, it starts in the breast ducts or glands and spreads outside the walls of the duct into the breast tissue, and can then spread into the nearby lymph nodes and beyond. Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread.

Locally advanced breast cancer is seen when the breast, skin or chest wall is affected. Signs and symptoms may be:

1. A change in the size, contour, texture or temperature of their breast. A reddish, pitted surface (like the skin of an orange) could be a sign of metastatic breast cancer.

2. If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.

3. If the lungs are affected, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.

4. If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection, and yellowing or itchy skin.

5. If the brain or spinal cord is affected, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech and difficulty with movement or seizures.

Unfortunately, breast cancer not only affects the breast, but it can have a devastating impact on other organs if left untreated. Fortunately, most of us live in a society where technology is readily available and men and women can arm themselves with information that can save their lives. The first step is education and awareness. Know your true risk for developing breast cancer. Once you know your true risk, talk to your healthcare provider and start your screening with a mammogram!